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Richmond Police Department Crisis Intervention Training Updated March 27, 2017
Richmond Police Department
Crisis Intervention Training
Updated March 27, 2017
General Categories◦ Dementia
◦ Autism Spectrum Disorders
◦ Intellectual Disabilities
Interactions with law enforcement personnel
Intervention and communication strategies
Definition◦ An umbrella term for a group of cognitive disorders
typically characterized by memory impairment & difficulty in the domains of language, motor activity, object recognition, and disturbance of executive function
Common Symptoms (The 4 A’s)◦ Amnesia: Loss of memory (short- and long-term)
◦ Aphasia: Loss of language (use and understanding)
◦ Agnosia: Inability to recognize people/objects
◦ Apraxia: Inability to coordinate purposeful movement
www.cdc.gov
Major types◦ Primary Neurodegenerative Irreversible Dementias
Alzheimer’s Parkinson’s Huntington’s Vascular Dementia/Stroke
◦ Secondary Reversible Dementias Excessive substance use and drug interactions Periodontal and metabolic diseases Anxiety and depression Chronic stress and sleep problems/disorders
◦ Traumatic Brain Injury MVA Falls Assaults Military service Sports injuries
www.cdc.gov
Trouble processing/remembering information
Not follow instructions
Seem belligerent or unmotivated
Experience headaches and fatigue
Become easily frustrated
Not perceive how behaviors affect others; relationships can become strained
Lose impulse control; may do or say things that are not socially appropriate
Become emotionally volatile; may have outbursts of anger, aggression, or crying
https://www.arcnc.org/images/ResourceGuide.pdf
Common signs◦ Asking the same question over and over◦ Inability to do complex tasks (e.g., cooking a meal)◦ Becoming lost in once-familiar places◦ Forgetting names of familiar people, places, things◦ Mental confusion
Law enforcement interactions◦ Wandering◦ Erratic driving◦ False reports and victimization◦ Indecent exposure◦ Shoplifting◦ Aggressive behavior
www.alz.org/safereturn
Definition ◦ A group of developmental disabilities that can
cause significant social, communication and behavioral challenges
Diagnostic Criteria◦ Deficits in social communication and social
interaction across multiple contexts
◦ Restricted, repetitive patterns of behavior, interests, or activities
www.cdc.gov; Diagnostic and Statistical Manual of Mental Disorders (DSM-5)
Limited eye contact
Have difficulty with communication◦ May not talk (nonverbal)
◦ May communicate with sign language, picture cards or gestures
◦ May have trouble understanding what YOU say
◦ May need direct, short instructions
◦ May have a delayed response to questions
◦ May not read facial expressions or body language
Unknowingly invade others’ personal space
Strong reactions to being touched
Odd behaviors such as flapping hands or pacing
https://www.arcnc.org/images/ResourceGuide.pdf
Law enforcement interactions◦ Difficulties following verbal commands◦ Sensitivity to sensory stimulation◦ May not recognize the meaning of visual clues (e.g., badge,
uniform, vehicle)◦ May not respond to questions in expected ways (e.g., not at
all, repeating/echoing what is said)◦ Difficulty judging acceptable physical distance◦ May attempt to flee the area without understanding of the
consequences◦ Avoidance of eye contact can seen deceitful/suspicious◦ Repetitive motions or sounds can be unpredictable
www.autismspeaks.org/docs/family_services_docs/LawEnforcement.pdf; www.officer.com/article/10880086/law-enforcement-and-autism;
Diagnostic Criteria◦ Onset before the age of 18◦ Intellectual ability assessed to be significantly below
average (IQ below 70)◦ Deficits in adaptive functioning
Adaptive Functioning◦ Conceptual (Communication, Functional Academics,
Self-Direction)◦ Practical (Community Use, Home Living, Health &
Safety, Self-Care)◦ Social (Leisure, Social)
May not communicate at age level◦ Limited vocabulary◦ Difficulty understanding/answering questions◦ Mimics answers/responses◦ Unable to communicate events clearly in his/her own words◦ Difficulty with complicated instructions or abstract concepts
May not understand consequences of situations ◦ Unaware of seriousness of situations◦ Easily led or persuaded by others◦ Naïve eagerness to confess or please authority figures
May not behave appropriately◦ Unaware of social norms and appropriate social behavior◦ Acts younger than actual age, may display childlike behavior◦ Displays low frustration tolerance and/or poor impulse control◦ May “act out”, become emotional, or try to leave if under pressure
May have difficulty performing tasks◦ Inability to read or write, tell time◦ Difficulty staying focused and easily distracted◦ Awkward/poor motor coordination
https://www.arcnc.org/images/ResourceGuide.pdf
As suspects…◦ not want their disability to be recognized (and try to
cover it up)◦ not understand their rights, but pretend to understand◦ not understand commands, instructions, etc.◦ be overwhelmed by police presence◦ act upset at being detained and/or try to run away◦ say what they think officers want to hear◦ have difficulty describing facts or details of offense◦ be the first to leave the scene of the crime, and the first
to get caught◦ be confused about who is responsible for the crime and
"confess" even though innocent
People with Intellectual Disabilities in theCriminal Justice System: Victims & Suspects (www.thearc.org)
As victims…◦ be easily victimized and targeted for victimization
◦ be less likely or able to report victimization
◦ be easily influenced by and eager to please others
◦ think that how they have been treated is normal and not realize the victimization is a crime
◦ think the perpetrator is a “friend”
◦ be unaware of how serious or dangerous the situation is
◦ not be considered as credible witnesses, even in situations where such concern is unwarranted
◦ have very few ways to get help, get to a safe place or obtain victim services or counseling
People with Intellectual Disabilities in theCriminal Justice System: Victims & Suspects (www.thearc.org)
Psychopharmacology
Talk therapy (individual, group, family)
Positive behavior supports (home-, school-or community-based)
Skill training (independent living, social, vocational)
Addressing specific cognitive deficits (environmental/behavioral modifications)
Medical emergencies
Aggressive behavior toward self or others
Inappropriate behavior in a public setting
Victim of crime or abuse
Perpetrator of crime or abuse
“Wandering”, “runaway”, or search-and-rescue
Request for assistance (family, group home, service provider)
Identify yourself and explain why you’ve approached the person
Carefully use eye contact and touch◦ Explain what you are doing and why
Speak calmly and use simple language◦ Break questions/information into smaller “chunks”◦ Consider using “yes” or “no” questions
Slow the pace ◦ Ask one question at a time◦ Repeat the question as needed◦ Give one direction at a time
www.alz.org/safereturn; www.autismspeaks.org/docs/family_services_docs/LawEnforcement.pdf;
http://www.arcnc.org/partners-in-justice
Explore other communication options◦ Alternative methods (e.g., communication device)
◦ Alternative means (e.g., asking in a different way)
Keep in mind that individuals may be overly agreeable; check understanding along the way
Behaviors that seem deliberate, disrespectful or hostile may not be…
Be patient
www.alz.org/safereturn; www.autismspeaks.org/docs/family_services_docs/LawEnforcement.pdf;
http://www.arcnc.org/partners-in-justice
Serves children, adolescents and adults with Intellectual and Developmental Disabilities with challenging behaviors and mental health needs.
Available 24/7 to provide crisis response Does not replace Emergency Services but is
ancillary to them REACH’s mission is to reduce the likelihood of
negative outcomes such as unnecessary hospitalization or incarceration for individuals with disabilities who are in crisis.
HOTLINE: 855-282-1006
*REACH Brochure is included in your handouts
Types◦ Goal-directed (trying to get to somewhere or
something)◦ “Bolting” or fleeing (usually to get away from
something)◦ Other (becoming lost/disoriented, boredom)
Concerns◦ Difficulty providing identification◦ Difficulty assessing risk & attraction to dangerous
areas (e.g., water)◦ Difficulty responding to rescuers◦ Eluding or hiding from search teams
http://nationalautismassociation.org/docs/BigRedSafetyToolkit-FR.pdf; http://www.alzfdn.org/documents/Lost&Found_forweb.pdf
Effective July 1, 2014
VOLUNTARILY addition of a special indicator code on Virginia DMV issued driver's licenses or ID cards◦ IntD: Intellectual Disability
◦ ASD: Autism Spectrum Disorder *Restriction identified by ‘9’ on front; Code (IntD or ASD) on back
Special indicator codes have been selected because they impact communication abilities
Not everyone with an IntD/ASD will have this code
Orientation◦ Person, place, time, and purpose
Attention and Concentration◦ “Serial 7s” or spelling backwards
Memory◦ Repeating brief list of words, recalling later
◦ Questions about well-known information
The Greater Richmond ARC
Area 25 (Richmond) Special Olympics
The Greater Richmond Chapter of the Alzheimer's Association
Commonwealth Autism Service
Autism Society of Central Virginia
Down Syndrome Association of Greater Richmond
St. Joseph’s Villa
JPJumPers Foundation
REACH
